| NPI | 1962031344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 85463) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME167438) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2025-07-01 |