| NPI | 1659646834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 042.0017023) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME134637) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2026-04-24 |