| NPI | 1104104082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 283857) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 283857) |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2025-06-03 |