| NPI | 1376513028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD061376L) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 222433) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2019-01-18 |