| NPI | 1740215631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME157402) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 038177) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2022-09-16 |