| NPI | 1730479692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 68680) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 279980) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2022-08-30 |