| NPI | 1336145549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME142624) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 221516) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2026-06-15 |