| NPI | 1437507613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME144286) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN22771) |
| 207L00000X Anesthesiology (Licence: MI 4301505213) | |
| Enumeration Date | 2016-05-29 |
| Last Update Date | 2025-11-10 |