| NPI | 1811935216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME 88686) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA05490200) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2008-06-19 |