| NPI | 1477880615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME133117) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA07210100) |
| 207L00000X Anesthesiology (Licence: MI 4301512785) | |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2026-01-06 |