| NPI | 1699160226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 85695) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME143306) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2025-12-10 |