| NPI | 1558940767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 320124) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MTL2000392) |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2023-02-17 |