| NPI | 1710449475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME170506) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 92983) |
| 207L00000X Anesthesiology (Licence: GA 92983) | |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2024-10-17 |