| NPI | 1790139459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME154263) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0067117) |
| 207L00000X Anesthesiology (Licence: ME MD23783) | |
| 207L00000X Anesthesiology (Licence: TX S1994) | |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2022-08-19 |