| NPI | 1750878260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 1018953) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 315688) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2024-08-06 |