| NPI | 1104916139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME88516) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 45481) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-07-27 |