| NPI | 1689092306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME134902) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 51369) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2022-06-10 |