| NPI | 1215924196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME116362) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 68146) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2024-06-21 |