| NPI | 1326508359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 322515) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME166706) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2025-06-15 |