| NPI | 1306075585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME 118313) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME118313) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME118313) | |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2020-11-13 |