| NPI | 1659318202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME154959) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD00035215) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2025-11-21 |