| NPI | 1114925765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME165853) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 213579-1) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2024-12-11 |