| NPI | 1801033634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 251569) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME129364) |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2025-09-24 |