| NPI | 1073802500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 273911) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 273911) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2016-11-04 |