| NPI | 1518125152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 52244) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME163768) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2023-08-18 |