| NPI | 1871662361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME133099) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 002681-1) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2018-08-27 |