| NPI | 1548402969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME150880) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2012-02149) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NC 2012-02149) | |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2021-07-16 |