| NPI | 1114929031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 030353) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME129931) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2018-03-17 |