| NPI | 1275093445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 326740) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 13274771-1204) |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2025-01-13 |