| NPI | 1407909443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 269293) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 235697) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-03-01 |