| NPI | 1508278557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 308557) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101264417) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2025-07-30 |