| NPI | 1184674897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME102049) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 00012698) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2009-01-05 |