| NPI | 1467870741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 292044) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME160764) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2026-05-28 |