| NPI | 1891959052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 243366) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 243366) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2013-01-31 |