| NPI | 1417997289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 15921) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL 164289) |
| 207L00000X Anesthesiology (Licence: NY 159389-1) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2023-10-30 |