| NPI | 1083891816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 261472) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 051400) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 261472) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CT 051400) | |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2023-07-19 |