| NPI | 1790277051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 321018) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 059548) |
| Enumeration Date | 2018-06-03 |
| Last Update Date | 2023-07-17 |