| NPI | 1417941816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 173669-2) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 173369-1) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2014-04-24 |