| NPI | 1649484429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME108908) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD438984) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2024-09-05 |