| NPI | 1831490051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101249187) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 259172) |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2017-08-29 |