| NPI | 1356506604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 243010) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS16385) |
| 207L00000X Anesthesiology (Licence: MD H70032) | |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2025-09-24 |