| NPI | 1891789160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 77513) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 002373-1) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2024-06-13 |