| NPI | 1376779918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 51939) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2010-01360) |
| 207L00000X Anesthesiology (Licence: FL ME164411) | |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2024-03-22 |