| NPI | 1679649255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MD H67019) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 222158) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 225891) | |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2011-11-23 |