| NPI | 1578551073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 143733) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G54857) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA G54857) | |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2025-04-22 |