| NPI | 1649231812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 239179) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 235403) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2025-03-12 |