| NPI | 1215399886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME148233) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 268489) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2024-01-10 |