| NPI | 1174596332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NY 171377) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 171377-1) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2022-07-21 |