| NPI | 1821397019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME153898) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 268694-1) |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2025-12-22 |