| NPI | 1811928252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 257719) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 057485) |
| 207L00000X Anesthesiology (Licence: SC TL30424) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2015-01-09 |