| NPI | 1588640726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME165157) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 28507) |
| 207L00000X Anesthesiology (Licence: MS 15112) | |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2023-12-07 |