| NPI | 1467514497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 170839) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 170839) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2025-01-07 |