| NPI | 1669404729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME154903) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 55099-020) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2025-02-03 |