| NPI | 1801864293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME94004) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101056805) |
| 207L00000X Anesthesiology (Licence: NY 200609) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2024-09-18 |