| NPI | 1619956281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME78229) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME 78229) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2021-06-25 |