| NPI | 1871536953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 201788) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 041901) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2016-03-21 |