| NPI | 1760455810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 262431) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 34432) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2011-11-30 |