| NPI | 1710109129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME155063) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT185884) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2022-05-16 |