| NPI | 1316927536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0051360) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD427929) |
| 207L00000X Anesthesiology (Licence: FL ME 95864) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2015-10-05 |