| NPI | 1538157201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 262908) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 39803-020) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2021-07-15 |