| NPI | 1073698155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME103466) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 044013) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2019-04-05 |