| NPI | 1891351987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 321521) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA MD-55323) |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2025-10-28 |