| NPI | 1629502992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 325807) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301503712) |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2024-12-16 |