| NPI | 1528687613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 335719) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 1019513) |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2025-08-03 |