| NPI | 1487282695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 329786-01) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 329786-01) |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2025-06-30 |