| NPI | 1669632618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 256205-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME128128) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2024-01-04 |