| NPI | 1669685335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 239762) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME154919) |
| 207L00000X Anesthesiology (Licence: CT 047757) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2025-02-21 |