| NPI | 1609860980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 138302) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 29393) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2019-08-12 |