| NPI | 1932104866 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 191607) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 191607) | 
| Enumeration Date | 2005-06-16 | 
| Last Update Date | 2025-09-11 |