| NPI | 1811258262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 329374) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 53889) |
| 208600000X Surgery (Licence: AZ R73387) | |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2024-05-30 |