| NPI | 1790714244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL me72650) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: FL ME72650) |
| 208600000X Surgery (Licence: FL ME72650) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME72650) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2024-03-08 |