| NPI | 1568606929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 052759) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 258940) |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2015-12-13 |