| NPI | 1003076415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME126745) |
| Additional Taxonomies | 202D00000X Integrative Medicine (Licence: FL ME126745) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2026-01-07 |