| NPI | 1376777847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 271251) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301 094 085) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2015-04-17 |