| NPI | 1457312076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME101087) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101233922) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2011-05-25 |