| NPI | 1982680963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 27496) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME139733) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2020-08-04 |