| NPI | 1053393454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME97745) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 33804) |
| Enumeration Date | 2005-11-19 |
| Last Update Date | 2012-06-21 |