| NPI | 1053302109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME104166) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 016875) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2012-09-25 |