NPI | 1578026548 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 3013528) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 3013528) |
Enumeration Date | 2019-04-08 |
Last Update Date | 2025-08-21 |