| NPI | 1245228758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME137771) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 200301262) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2018-10-23 |