| NPI | 1700854528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME78349) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA RN045080L) |
| 207L00000X Anesthesiology (Licence: KY 39390) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2024-02-23 |