| NPI | 1376097238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME153212) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 312814) |
| 204F00000X Transplant Surgery (Licence: WA 60662744) | |
| 208D00000X General Practice (Licence: NY 312814) | |
| 208D00000X General Practice (Licence: FL 153212) | |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2026-03-10 |