| NPI | 1659346591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301077436) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME176459) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2026-01-16 |