| NPI | 1184614802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 207852) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME135721) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2023-12-06 |