| NPI | 1770589582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 59939) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 174859-1) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2022-01-07 |