| NPI | 1497042105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 279567) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT200326) |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2016-03-30 |