| NPI | 1932174679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101228979) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME130253) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2025-01-06 |