| NPI | 1528218526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME113799) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 149930) |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2012-09-04 |