| NPI | 1528053105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME 76918) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX K1549) |
| 207L00000X Anesthesiology (Licence: ME 10509) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2015-11-18 |