| NPI | 1518062967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 128361-1) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 128361) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2016-09-12 |