| NPI | 1558895201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0102209873) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS19220) |
| 207L00000X Anesthesiology (Licence: NY 310721) | |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2026-02-24 |