| NPI | 1124238035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME116311) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 248483) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2013-08-14 |