| NPI | 1750369609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME115758) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 9500714) |
| Enumeration Date | 2006-01-01 |
| Last Update Date | 2023-10-13 |