| NPI | 1134104714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME114861) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 213642) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2013-08-09 |