| NPI | 1003010299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME108965) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN11437) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2011-08-10 |