| NPI | 1831589316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME156883) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A167758) |
| 207L00000X Anesthesiology (Licence: WI 83142-20) | |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2024-11-15 |