| NPI | 1376605063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2014-01726) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY MD426588) |
| Enumeration Date | 2006-12-16 |
| Last Update Date | 2014-08-28 |