| NPI | 1891855870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME124927) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 060883) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2016-06-30 |