| NPI | 1801042551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME149874) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 051000) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2023-04-25 |