| NPI | 1336437573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME 127775) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA MD-56985) |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2026-07-17 |