| NPI | 1417023995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME132731) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101236898) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2024-01-22 |