| NPI | 1487807533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME103797) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL 9251) |
| Enumeration Date | 2008-11-01 |
| Last Update Date | 2018-12-27 |