| NPI | 1669400628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 156344) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME MD27576) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2026-01-14 |