| NPI | 1184831133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME119509) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101236601) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2017-11-22 |