| NPI | 1073592242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME72116) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD423714) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2014-06-04 |