| NPI | 1578568457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 35909) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME MD29857) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2025-09-22 |