| NPI | 1598185290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME166293) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301105233) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2024-02-22 |