| NPI | 1124013610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME56781) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD034345E) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2018-03-07 |