| NPI | 1902002918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0074302) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME 017341) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2012-10-25 |