| NPI | 1699124990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 305231) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 266939) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2020-09-01 |