| NPI | 1316382088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME127332) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 265632) |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2021-05-11 |