| NPI | 1679677694 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 14368) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME 018682) | 
| Enumeration Date | 2006-09-11 | 
| Last Update Date | 2018-10-01 |