| NPI | 1467945485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME164012) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT215749) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2023-11-06 |