| NPI | 1124055249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA MD.024192) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 024192) |
| 207L00000X Anesthesiology (Licence: FL ME159857) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2023-06-08 |