| NPI | 1326301607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME127300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 252290) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2017-04-17 |