| NPI | 1619915709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 248718) |
| Additional Taxonomies | 174400000X Specialist (Licence: DC md33957) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2022-05-02 |