| NPI | 1912097486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME124825) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR R-4477) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2015-11-16 |