| NPI | 1093800468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 199846-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ MA58374) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |