| NPI | 1679505259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME91715) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA C166627) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-03-18 |