| NPI | 1649275942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 231771) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD444613) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2015-03-30 |