| NPI | 1982621892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 041190) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 309044) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2025-04-25 |