| NPI | 1528149622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME105910) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN10301) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2010-11-23 |