| NPI | 1659021731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 292996) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 340975) |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2026-06-08 |