| NPI | 1265752414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0076104) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME 107126) |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2013-07-01 |