| NPI | 1952658320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME148577) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 35813) |
| Enumeration Date | 2012-08-05 |
| Last Update Date | 2021-06-29 |