| NPI | 1831473495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 279929-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 279929) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2015-07-30 |