| NPI | 1639336910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2011-00548) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 260853) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2023-01-20 |