| NPI | 1548429418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101277980) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 283706) |
| 207L00000X Anesthesiology (Licence: MD D0067749) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2023-06-04 |