| NPI | 1326296310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N3000) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL 9167) |
| 207L00000X Anesthesiology (Licence: FL ME103913) | |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2022-09-20 |