| NPI | 1962961813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: MD D0102794) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0102794) |
| 207L00000X Anesthesiology (Licence: NY 320658) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: NY 320658) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2025-08-27 |