| NPI | 1548285687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME114394) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD423579) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2013-06-17 |