| NPI | 1912418666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 318232) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MB11160300) |
| Enumeration Date | 2017-10-21 |
| Last Update Date | 2023-06-05 |