| NPI | 1659377794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL 117589) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 194035-1) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2019-04-15 |