| NPI | 1851438303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME131884) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL MD.32664) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2025-04-11 |