| NPI | 1164782090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME126019) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME126019) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2022-02-25 |