| NPI | 1376534990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME163307) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 95168) |
| 207L00000X Anesthesiology (Licence: TN 38601) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2023-06-30 |