| NPI | 1831547512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME174912) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 63137) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2025-07-21 |