| NPI | 1659480002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2006009452) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2006009452) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MO 2006009452) | |
| 207L00000X Anesthesiology (Licence: FL ME147731) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2026-06-09 |