| NPI | 1265596233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME103972) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT185851) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2009-11-09 |