| NPI | 1750319364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME 102965) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX M2613) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2012-11-09 |