| NPI | 1154587988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME117457) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 57529) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2016-08-25 |