| NPI | 1881690733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 190657-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 73586) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2023-12-11 |