| NPI | 1831658962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME147422) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN29266) |
| 207R00000X Internal Medicine (Licence: FL TRN29266) | |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2021-08-02 |