| NPI | 1053382762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME94584) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 001771) |
| 207L00000X Anesthesiology (Licence: FL ME 94584) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2023-04-19 |