| NPI | 1992968473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 255964) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2011009934) |
| Enumeration Date | 2008-07-06 |
| Last Update Date | 2023-07-03 |