| NPI | 1073740429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 53068) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 260611) |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2015-11-17 |