| NPI | 1669430898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 239932) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 52380-020) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2018-12-12 |