| NPI | 1285800433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 050707) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 262567) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2012-06-15 |