| NPI | 1568414654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME104385) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301080938) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2015-04-28 |