| NPI | 1861020109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME173999) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX U9004) |
| 208VP0000X (Licence: FL ME173999) | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2025-07-17 |