| NPI | 1689135725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 1024661) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 322927) |
| Enumeration Date | 2019-03-30 |
| Last Update Date | 2026-02-02 |