| NPI | 1497986673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME147780) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MA 240701) |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2023-04-05 |