| NPI | 1952350704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME161194) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101235116) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2023-10-04 |