| NPI | 1043290786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301097405) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME 89944) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2019-12-05 |