| NPI | 1659868735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME164500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 316984-01) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2024-03-29 |