| NPI | 1639158934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME63018) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME-63018) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2012-08-28 |