| NPI | 1255579553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 252875) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 047674) |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2010-07-14 |