| NPI | 1124001433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME0078615) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 9401364) |
| 207L00000X Anesthesiology (Licence: AL 23516) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2017-10-19 |