| NPI | 1104611953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 342337-01) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 342337-01) |
| Enumeration Date | 2025-04-11 |
| Last Update Date | 2026-09-10 |