NPI | 1043607518 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL 144891) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 303753) |
207LP2900X Anesthesiology, Pain Medicine (Licence: FL 144891) | |
207LP2900X Anesthesiology, Pain Medicine (Licence: NY 303753) | |
Enumeration Date | 2015-04-22 |
Last Update Date | 2021-12-17 |