| NPI | 1629042957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME94455) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 020641) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2024-01-11 |