| NPI | 1669976668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 307121) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 79558) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2024-10-15 |