| NPI | 1043969272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME170089) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA MD-49484) |
| Enumeration Date | 2022-03-23 |
| Last Update Date | 2025-12-05 |