| NPI | 1801386297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 308780) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 275915) |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2022-11-04 |