| NPI | 1821095209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME95543) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA04383800) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2009-12-14 |