| NPI | 1356338024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 47944) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 14821) |
| 207L00000X Anesthesiology (Licence: NY 255832) | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2017-03-24 |