| NPI | 1972913689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: GA 101011) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 295039) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2025-04-23 |