| NPI | 1083604987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME0066325) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 93592) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2025-03-11 |