| NPI | 1962865923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME144295) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD472263) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2026-06-08 |