| NPI | 1366460610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME103324) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 26112) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2010-05-04 |