| NPI | 1689995771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME138578) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 279563) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: VA 0101271950) | |
| Enumeration Date | 2010-06-12 |
| Last Update Date | 2022-10-12 |