| NPI | 1205871902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME167800) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD209884) |
| 207L00000X Anesthesiology (Licence: DE C1-0006903) | |
| 207L00000X Anesthesiology (Licence: PA MD420812) | |
| 207L00000X Anesthesiology (Licence: ME MD27862) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2024-08-02 |