| NPI | 1760641161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 245312) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 245312) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2017-05-08 |