| NPI | 1417101411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME125933) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME125933) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 245325) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME125933) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MA10265600) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME125933) | |
| 207L00000X Anesthesiology (Licence: NY 60245325) | |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2025-09-16 |