| NPI | 1629654223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME171203) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 96886) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2026-08-14 |