| NPI | 1558741124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME148804) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 298088) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2022-09-21 |