| NPI | 1316943962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 143331) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0020875) |
| 207L00000X Anesthesiology (Licence: MA 46221) | |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2012-09-17 |