| NPI | 1174885776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME 127397) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DC MD 042258) |
| 207L00000X Anesthesiology (Licence: NY 284292) | |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2018-07-11 |