| NPI | 1265714786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 76244) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME168648) |
| Enumeration Date | 2011-09-10 |
| Last Update Date | 2024-06-14 |