| NPI | 1982865671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS11723) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 248933-1) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2025-02-04 |