| NPI | 1851558928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME 103130) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 236501) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2013-03-13 |