| NPI | 1285677120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101057502) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME104878) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2022-07-21 |