| NPI | 1154337285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 232294) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 07277400) |
| 207L00000X Anesthesiology (Licence: PA MD441816) | |
| 207L00000X Anesthesiology (Licence: DE C1-0012943) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2023-03-16 |