| NPI | 1902165426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 278624-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 278624) |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2015-09-14 |