| NPI | 1972579100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ME MD21721) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 225492) |
| 207L00000X Anesthesiology (Licence: NY 236849) | |
| 207L00000X Anesthesiology (Licence: NH 13200) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2017-10-18 |