| NPI | 1558389197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 59531) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2010007563) |
| 207L00000X Anesthesiology (Licence: FL ME116037) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2014-11-27 |