| NPI | 1700942646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 33892) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 240694-1) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2012-06-06 |