| NPI | 1861690679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 242364) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 248617-1) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2012-04-20 |