| NPI | 1619931193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 197798) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD057008L) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2026-01-20 |