| NPI | 1851552848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 254449) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NY 254449) |
| 207L00000X Anesthesiology (Licence: CT 57039) | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2026-07-08 |