| NPI | 1710913819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 15445) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME73967) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2014-10-16 |