| NPI | 1346414836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 301872-01) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 69465) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2022-05-17 |