| NPI | 1720487085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 292537) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 73875) |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2023-08-29 |