| NPI | 1770915308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 310648) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: GA 90278) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: AL MD.36837) | |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2025-07-29 |