| NPI | 1588817696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 69943) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME132479) |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2025-09-24 |