| NPI | 1649858929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 104283) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME170092) |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2025-08-31 |