| NPI | 1730749763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 280977) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 280977) |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2023-09-18 |