| NPI | 1730162280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 53692) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 147669) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2025-02-10 |