| NPI | 1821451147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301109622) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME151318) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2024-03-13 |