| NPI | 1750359394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME102331) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 214871) |
| 207L00000X Anesthesiology (Licence: MO 2003001130) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2018-08-23 |