| NPI | 1033571849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 310190) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME145089) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2021-07-27 |