| NPI | 1134317266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME106049) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA MD.204864) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2014-07-18 |