| NPI | 1861710758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 94037) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 00000000000) |
| 207L00000X Anesthesiology (Licence: NY 284306) | |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2023-01-18 |