| NPI | 1740430743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM MD2016-0079) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA09170600) |
| 207L00000X Anesthesiology (Licence: NY 251300) | |
| 207L00000X Anesthesiology (Licence: TX P3063) | |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2022-07-21 |