| NPI | 1124152368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD210831) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME95401) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2023-07-21 |