| NPI | 1114555414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 340359) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 340359) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 340359) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 340359) | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2026-09-01 |