| NPI | 1891971933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD H0076579) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 234373) |
| 207Q00000X Family Medicine (Licence: NY 234373) | |
| 207L00000X Anesthesiology (Licence: CT 047202) | |
| 207Q00000X Family Medicine (Licence: CT 047202) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CT 047202) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 234373) | |
| Enumeration Date | 2008-01-19 |
| Last Update Date | 2013-08-21 |