| NPI | 1891821211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME107037) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME107037) |
| 207L00000X Anesthesiology (Licence: MA L-226216) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2019-09-23 |