| NPI | 1821580739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 316827) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: NY 316827) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2024-05-15 |