| NPI | 1174865489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME170624) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 291062) |
| 207L00000X Anesthesiology (Licence: IL 036144738) | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2026-04-20 |