| NPI | 1780667485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 181228) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 181228) |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2008-11-14 |