| NPI | 1225281645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P0127) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 250836-1) |
| 207R00000X Internal Medicine (Licence: NY 250836-1) | |
| 208600000X Surgery (Licence: NY 250836-1) | |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2022-10-25 |