| NPI | 1306009766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 333092) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 253304) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2025-02-26 |