| NPI | 1962709519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME125451) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL MD.35871) |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2026-02-03 |