| NPI | 1861562282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME143548) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G57261) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2025-04-30 |