| NPI | 1720220643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DC 151175) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 253561) |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2013-06-14 |