| NPI | 1518969872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 226352) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA07386200) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2022-11-28 |