| NPI | 1770980336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 411330) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 411330) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2024-07-30 |