| NPI | 1922245208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 244763) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 244763-1) |
| 207L00000X Anesthesiology (Licence: NY 244763-1) | |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2017-08-28 |