| NPI | 1306368683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 313831) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301506127) |
| Enumeration Date | 2017-07-08 |
| Last Update Date | 2023-02-05 |