| NPI | 1801192109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD154258) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 259338-1) |
| Enumeration Date | 2011-02-03 |
| Last Update Date | 2024-05-15 |