| NPI | 1053790485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 60656) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME MD28167) |
| 207L00000X Anesthesiology (Licence: MN 27428) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 60656) | |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2024-05-09 |