| NPI | 1548257181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 47970) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME39589) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2007-07-13 |