| NPI | 1679701627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 281264) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NY 281264) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2016-12-27 |