| NPI | 1811936040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0071887) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 169105) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2025-03-03 |