| NPI | 1144227976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 225713) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MA75669) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2015-06-04 |