| NPI | 1528057817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME152928) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 15320) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2021-12-30 |