| NPI | 1134782436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 337189) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME161648) |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2025-08-06 |