| NPI | 1326044272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 202690) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD429643) |
| 207L00000X Anesthesiology (Licence: MD D0062243) | |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2015-04-13 |