| NPI | 1134189715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL 81216) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 145134) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2019-08-29 |