| NPI | 1619056058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME166096) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 29673) |
| Enumeration Date | 2006-11-05 |
| Last Update Date | 2025-01-31 |