| NPI | 1710962923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 46175) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 231869) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2020-09-10 |