| NPI | 1275518409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA 451804) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 226349) |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: PA 451804) | |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2021-10-08 |