| NPI | 1942576988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301502256) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 272868-1) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2020-07-09 |