| NPI | 1366002784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 331931) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 280905) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2024-10-24 |