| NPI | 1295876621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME150096) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 42630) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2022-10-24 |