| NPI | 1023645082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 111322-01) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 832618553) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2021-10-18 |