| NPI | 1386806248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS9740) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: FL OS9740) |
| 207L00000X Anesthesiology (Licence: NY 258288) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2012-06-06 |