| NPI | 1811158207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME127376) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH EL13472) |
| 207L00000X Anesthesiology (Licence: MA 258910) | |
| 207L00000X Anesthesiology (Licence: NY 277982) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2024-01-11 |