| NPI | 1104068725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 104644) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 246726-1) |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2025-09-16 |