| NPI | 1134394364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME170589) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 30914) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2025-12-18 |