| NPI | 1265752653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME164106) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2015-01089) |
| 207L00000X Anesthesiology (Licence: SC MD32601) | |
| 208600000X Surgery (Licence: SC LL32601) | |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2024-06-28 |