| NPI | 1730359241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 12779) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 242301) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2023-06-29 |