| NPI | 1063584274 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 21232) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME MD14746) | 
| Enumeration Date | 2006-11-14 | 
| Last Update Date | 2021-03-09 |