| NPI | 1013996685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME33803) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME-33803) |
| 207L00000X Anesthesiology (Licence: FL ME 33803) | |
| 207L00000X Anesthesiology (Licence: TX J3469) | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2021-01-12 |