| NPI | 1215496252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 344372-01) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0093606) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MD D0093606) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2026-08-25 |