| NPI | 1922445857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD 6274) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME135714) |
| Enumeration Date | 2013-06-02 |
| Last Update Date | 2026-03-04 |