| NPI | 1538665476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 340123) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 11415604-1205) |
| Enumeration Date | 2018-03-31 |
| Last Update Date | 2025-11-05 |