| NPI | 1881679546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME138288) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 8561) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2022-03-17 |