| NPI | 1609039247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD442181) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME136931) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2024-11-15 |