| NPI | 1417247420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 281273-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 26588) |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2016-11-18 |