| NPI | 1083710677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME117308) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ MA51226) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2023-05-27 |