| NPI | 1366558819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2022-00644) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 216872-1) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2022-04-22 |