| NPI | 1518944388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 138929) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 1389292) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2021-08-24 |