| NPI | 1659878510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 313298) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 313298-01) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2024-12-05 |