| NPI | 1457371171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME122169) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 18496) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2017-12-13 |