| NPI | 1710916515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME151622) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA 072207) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2025-02-24 |