| NPI | 1619071354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME151187) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0054453) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2023-08-10 |