| NPI | 1750453635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME103907) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN9094) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2009-09-29 |