| NPI | 1396701439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME135702) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 37107) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2018-09-26 |