| NPI | 1598990475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A125578) |
| Additional Taxonomies | 202K00000X (Licence: CA A125578) |
| 207L00000X Anesthesiology (Licence: NY 270247) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A125578) | |
| 207Q00000X Family Medicine (Licence: CA A125578) | |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2021-03-23 |