| NPI | 1588653653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101051126) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 186970) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2019-09-16 |