| NPI | 1215986658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M6549) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 55363) |
| 207L00000X Anesthesiology (Licence: FL ME125028) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2022-08-01 |