| NPI | 1538399738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME107561) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 252864) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2013-04-19 |