| NPI | 1013950880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME157049) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301060139) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2023-02-03 |