| NPI | 1467815878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101280199) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 312072) |
| Enumeration Date | 2016-04-02 |
| Last Update Date | 2023-11-02 |