| NPI | 1568476299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 60195) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 240606) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 240606) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2022-07-02 |