| NPI | 1275528408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME128889) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 212823) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2018-08-20 |