| NPI | 1558423244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60178903) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 201418) |
| Enumeration Date | 2006-12-16 |
| Last Update Date | 2019-01-31 |