| NPI | 1538145891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 75543) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 75543) |
| 207L00000X Anesthesiology (Licence: NY 320699-01) | |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2023-08-03 |