| NPI | 1285666859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME150741) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D39764) |
| 207L00000X Anesthesiology (Licence: NJ 25MA09513100) | |
| 207L00000X Anesthesiology (Licence: PA MD454056) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2024-12-05 |