| NPI | 1053815522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 324103-01) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX T7885) |
| 207L00000X Anesthesiology (Licence: FL ME148406) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2024-02-26 |