| NPI | 1023089620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME68278) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 270089-1) |
| 207L00000X Anesthesiology (Licence: NC 2011-01321) | |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2023-09-07 |