| NPI | 1902170673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV DO2048) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 339509) |
| Enumeration Date | 2012-02-28 |
| Last Update Date | 2025-09-18 |