| NPI | 1790928646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 72585) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 269879) |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2026-04-13 |