| NPI | 1578653044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME181198) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD420963) |
| 207L00000X Anesthesiology (Licence: AR E-3860) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2026-07-10 |