| NPI | 1588051742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101268500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME143654) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2023-04-09 |