| NPI | 1700045101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 52162) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 256863) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2022-09-13 |