| NPI | 1255314480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME125975) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 039310) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2016-01-15 |