| NPI | 1477601870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 161093) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 161093) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2013-10-07 |