| NPI | 1891714267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 314290) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD428436) |
| 207L00000X Anesthesiology (Licence: IL 36102137) | |
| 207L00000X Anesthesiology (Licence: NH 20121) | |
| 207L00000X Anesthesiology (Licence: KY 50113) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2023-06-20 |