| NPI | 1790985596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 246571) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 047086) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2015-01-26 |