| NPI | 1063450286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 197761-01) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G50086) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2023-07-20 |