| NPI | 1790781490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 177964) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 12120) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2009-11-06 |