| NPI | 1568400117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME106771) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MD D0056209) |
| 207T00000X Neurological Surgery (Licence: FL ME106771) | |
| 2085N0700X (Licence: FL ME106771) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2024-01-24 |