| NPI | 1952538217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DC MD038732) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 245866-1) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2021-06-07 |