| NPI | 1528025830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 1612031) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD067029L) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2021-03-04 |