| NPI | 1245627702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA 449887) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 313143) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2025-05-08 |