| NPI | 1891174777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 303010) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT209096) |
| Enumeration Date | 2015-05-25 |
| Last Update Date | 2024-09-23 |