| NPI | 1538221015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 270594) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT188744) |
| 207L00000X Anesthesiology (Licence: MD D68596) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2023-03-16 |