| NPI | 1316173438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2012-01220) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME DO3015) |
| 207L00000X Anesthesiology (Licence: NH 20969) | |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2021-05-11 |