| NPI | 1740211408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 001334) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD435067) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2026-03-23 |