| NPI | 1811922453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 143091) |
| Additional Taxonomies | 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: NY 143091) |
| 2080B0002X Pediatrics, Obesity Medicine (Licence: NY 143091) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2018-11-30 |