| NPI | 1275686214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 261461) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 242318) |
| 207L00000X Anesthesiology (Licence: VA 0101248348) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2016-07-18 |