| NPI | 1619163284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 234278-01) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A97421) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2022-10-26 |