| NPI | 1144789256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME162856) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301509063) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2023-08-29 |