| NPI | 1841274917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME124692) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 33918-020) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2019-11-25 |