| NPI | 1811129018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 265269) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A108000) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2021-04-27 |