| NPI | 1932499563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME142876) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WV 27190) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME142876) | |
| Enumeration Date | 2011-04-16 |
| Last Update Date | 2026-06-24 |