| NPI | 1316238405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 272654) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 289810-1) |
| 207L00000X Anesthesiology (Licence: ME MD20558) | |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2018-03-17 |