| NPI | 1225017767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C52943) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME64317) |
| 174400000X Specialist (Licence: FL ME0064317) | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2018-08-21 |