| NPI | 1689746240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME103757) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA MD.203898) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2016-08-15 |