| NPI | 1811130891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME114878) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 47671) |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2013-07-12 |