| NPI | 1821311986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 62286) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 251789) |
| Enumeration Date | 2010-03-03 |
| Last Update Date | 2021-03-22 |