| NPI | 1568695286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD443564) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 292338) |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2023-05-12 |