| NPI | 1760814933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 256847) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 256847) |
| 207L00000X Anesthesiology (Licence: NY 292211) | |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2022-10-28 |