| NPI | 1922172279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME100778) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN8617) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2008-09-30 |