| NPI | 1669651758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 245213) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 245213) |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2019-08-20 |