| NPI | 1992905533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 265993) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA FK2524797) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2014-04-02 |