| NPI | 1245333111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME152097) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101235614) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2021-08-31 |