| NPI | 1588631766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME97392) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 20145) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2008-11-18 |