| NPI | 1093814261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 261268) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 230271) |
| 207L00000X Anesthesiology (Licence: NY 261268) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2011-06-09 |