| NPI | 1285893032 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 14339)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME152935)  | 
| Enumeration Date | 2008-06-06 | 
| Last Update Date | 2023-07-25 |