| NPI | 1679571194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME122154) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 186060) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2019-11-27 |