| NPI | 1922488568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME164409) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 72494) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2024-04-19 |