| NPI | 1033403407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME128105) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR E-11583) |
| 208000000X Pediatrics (Licence: FL ME 110408) | |
| 207L00000X Anesthesiology (Licence: GA 5462) | |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2021-11-23 |