| NPI | 1083793400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME103302) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN8860) |
| Enumeration Date | 2006-11-05 |
| Last Update Date | 2009-09-01 |