| NPI | 1679036453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-55029) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 328772) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: IA MD-55029) | |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2025-07-16 |