| NPI | 1982607255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 292013) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 021093) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2021-04-28 |