| NPI | 1669969291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 333241) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 75057) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2024-10-29 |