| NPI | 1952453102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 162541-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA04668800) |
| 207L00000X Anesthesiology (Licence: IL 036-111159) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2007-07-08 |