| NPI | 1366564205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME 98188) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101222111) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2021-08-02 |