| NPI | 1407241722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 97341) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 317232-01) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2023-12-28 |