| NPI | 1417163775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 282886) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 244989) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2025-09-15 |