| NPI | 1356370852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 47962) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2009-00758) |
| 207L00000X Anesthesiology (Licence: FL ME0063649) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2019-04-17 |