| NPI | 1801275763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301107001) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 340559) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2026-01-29 |