| NPI | 1780974279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME121962) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301504801) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2024-08-15 |