| NPI | 1346738937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME155733) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA12355700) |
| Enumeration Date | 2018-04-29 |
| Last Update Date | 2024-10-21 |