| NPI | 1114160660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 270209) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM MD2019-0902) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2026-01-20 |