| NPI | 1932105871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 168316) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME132043) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2022-03-18 |