| NPI | 1740263433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ME 012829) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 147526-1) |
| 207L00000X Anesthesiology (Licence: PA MD-052485-L) | |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2009-03-26 |