| NPI | 1528696788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME166558) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 69588) |
| 207R00000X Internal Medicine (Licence: MN 30853) | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2024-07-26 |