| NPI | 1306912191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 228883) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME87780) |
| Enumeration Date | 2006-11-26 |
| Last Update Date | 2018-12-18 |