| NPI | 1902954779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME112593) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 221548) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2022-03-30 |