| NPI | 1861703084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 275473) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 275473) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2021-05-05 |