| NPI | 1255529327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME100872) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2012017443) |
| 207L00000X Anesthesiology (Licence: FL TRN 8069) | |
| Enumeration Date | 2007-10-14 |
| Last Update Date | 2021-03-26 |