| NPI | 1710117098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME115748) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN#13782) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME115748) | |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2023-04-19 |