| NPI | 1720465628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 319975) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0100538) |
| 207L00000X Anesthesiology (Licence: PA MD467008) | |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2024-06-28 |