| NPI | 1164407821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 215880) |
| Additional Taxonomies | 2083B0002X Preventive Medicine, Obesity Medicine (Licence: NY 215880) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2023-12-01 |