| NPI | 1295790772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 52104) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 17769) |
| 207L00000X Anesthesiology (Licence: FL ME121322) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2024-08-08 |