| NPI | 1588127393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 329602) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 76740) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2024-05-21 |