| NPI | 1164910238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 324142) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 324142) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2024-06-27 |