| NPI | 1609885557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME144125) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101257369) |
| 207L00000X Anesthesiology (Licence: NC 2006-01111) | |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2025-02-03 |