| NPI | 1285860759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 274479-1) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NY 274479-1) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2015-07-31 |