| NPI | 1972809366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 004117-1) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: NY 61 004117) |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2016-05-25 |