| NPI | 1881703320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 244727) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA MD-54950) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: NY 244747) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2025-08-19 |