| NPI | 1417165770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 46332) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2007002740) |
| 207L00000X Anesthesiology (Licence: FL ME104430) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2022-12-12 |