| NPI | 1528231776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 225239) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME106088) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2025-01-22 |