| NPI | 1629557897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A156304) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 302944-01) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2023-02-25 |