| NPI | 1952520280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 268369-1) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: NY 268369-1) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2019-08-15 |