| NPI | 1730352691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 060527) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 60527) |
| 207L00000X Anesthesiology (Licence: FL ME 103695) | |
| 207L00000X Anesthesiology (Licence: NC 2008-00167) | |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2014-04-08 |