| NPI | 1447457296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME100847) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 200700638) |
| 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: FL ME100847) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2013-11-26 |