| NPI | 1982705703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M6094) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 228553) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-04-28 |