| NPI | 1275510117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME151453) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 34901) |
| 207L00000X Anesthesiology (Licence: MN 41841) | |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2021-10-25 |