| NPI | 1679639363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 263944) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT188632) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2015-01-06 |