| NPI | 1538401765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: NY 293456-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 293456-1) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2018-07-23 |