| NPI | 1811122716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 87673) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 252826-1) |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2021-10-22 |