| NPI | 1083023139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 326348) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 4054) |
| 207L00000X Anesthesiology (Licence: MD D0098900) | |
| Enumeration Date | 2014-08-02 |
| Last Update Date | 2025-03-31 |