| NPI | 1750588224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 274086) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX P5802) |
| 207L00000X Anesthesiology (Licence: PA OS017008) | |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2021-03-02 |