| NPI | 1457407983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MI 4301085116) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME161359) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2024-08-14 |