| NPI | 1578854162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME0119596) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 63875) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2021-12-28 |