| NPI | 1497736987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M1336) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME174506) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2025-07-28 |