| NPI | 1245506153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 042.0013609) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: VT 042.0013609) |
| 207L00000X Anesthesiology (Licence: NY 291101) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 291101) | |
| Enumeration Date | 2012-03-25 |
| Last Update Date | 2025-12-10 |