| NPI | 1912012212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME117854) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 200201194) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2016-09-15 |