| NPI | 1104093160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD450407) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME123482) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2025-02-07 |