| NPI | 1952383242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 255829) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301106392) |
| 207L00000X Anesthesiology (Licence: CO 0027739) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2023-10-20 |