| NPI | 1295809960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD458608) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL trn7704) |
| 207L00000X Anesthesiology (Licence: FL ME100934) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2016-09-08 |