| NPI | 1407029242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 270233) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME112796) |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2016-05-24 |