| NPI | 1801107727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 299757) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM MD2014-0545) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2021-12-16 |