| NPI | 1235112434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 157325-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 157325) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2025-08-26 |