| NPI | 1023434834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME137868) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX R2909) |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2025-07-08 |