| NPI | 1356306112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME100309) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL MFC1588) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2013-04-23 |