| NPI | 1598733677 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 253691) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 1925-320) | 
| Enumeration Date | 2006-03-14 | 
| Last Update Date | 2023-10-10 |