| NPI | 1316923238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 56467) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CT 56467) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 203332) | |
| 207L00000X Anesthesiology (Licence: NY 203332) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 203332) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2021-12-09 |