| NPI | 1881957876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR 119602) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME128740) |
| Enumeration Date | 2012-06-24 |
| Last Update Date | 2025-05-13 |