| NPI | 1710446828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME161901) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 82734) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2024-06-02 |