| NPI | 1841204211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 206656) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 206656) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2022-01-26 |