| NPI | 1336133784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME173405) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 209051-1) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2026-05-13 |