| NPI | 1609816594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 058823) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 231395) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2013-04-05 |