| NPI | 1013181700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 15923) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 250492) |
| 207L00000X Anesthesiology (Licence: ME MD19311) | |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2015-03-19 |