| NPI | 1427301266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 266623) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 051073) |
| 207L00000X Anesthesiology (Licence: PA MD446793) | |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2012-12-06 |