| NPI | 1497069512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME120091) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN#14900) |
| Enumeration Date | 2010-07-30 |
| Last Update Date | 2014-08-06 |