| NPI | 1700878535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME92894) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 34075) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2024-12-30 |