| NPI | 1528408887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 292236) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301103041) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2019-02-25 |