| NPI | 1083875348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME115572) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA R-8334) |
| 207L00000X Anesthesiology (Licence: MD D74352) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2013-12-12 |