| NPI | 1518027572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 189533) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NY 189533) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2013-09-12 |