| NPI | 1225008840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME57838) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 32000) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2022-04-21 |