| NPI | 1033255807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 229590) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 49483) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2023-07-05 |