| NPI | 1023086865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME108859) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD073547L) |
| 207L00000X Anesthesiology (Licence: CT 048350) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2016-04-25 |