| NPI | 1144294802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD418271) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 262776) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2017-02-07 |