| NPI | 1114091477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME107970) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN9093) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2010-09-22 |