| NPI | 1184889032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 249332) |
| Additional Taxonomies | 207LA0401X Anesthesiology Addiction Medicine (Licence: NY 249332) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: NY 249332) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: NY 249332) | |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2019-01-30 |