| NPI | 1386601607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 164589-01) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 1645891) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2021-06-14 |