| NPI | 1336464593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 258475-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 258475-1) |
| Enumeration Date | 2010-03-31 |
| Last Update Date | 2012-02-24 |