| NPI | 1972763639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL me145688) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 18182) |
| 207L00000X Anesthesiology (Licence: FL ME0145688) | |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: NE 25286) | |
| 208D00000X General Practice (Licence: NE 25286) | |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2022-07-21 |