| NPI | 1457379752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 237519-1) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 237519) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2008-01-31 |