| NPI | 1811557580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ME DO3788) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT019312) |
| Enumeration Date | 2019-06-16 |
| Last Update Date | 2024-07-10 |