| NPI | 1609277375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 318553-01) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME155334) |
| 207L00000X Anesthesiology (Licence: VA 0101279882) | |
| 207L00000X Anesthesiology (Licence: MD D0095474) | |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2025-06-20 |