| NPI | 1376571802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 181920) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ MB07360700) |
| 207L00000X Anesthesiology (Licence: PA OS007841L) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2016-09-30 |