| NPI | 1164427514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 173020) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 173020) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2011-11-28 |