| NPI | 1568625093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 206745) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 265700-1) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2018-04-17 |