| NPI | 1790770956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DE C10008937) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 196716) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: DE C10008937) | |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2011-09-26 |