| NPI | 1922096445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME137462) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 00 34044) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2019-04-20 |