| NPI | 1407152697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 263976-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 263976) |
| Enumeration Date | 2011-02-04 |
| Last Update Date | 2019-08-26 |