| NPI | 1942207352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME 85156) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN MD0000037590) |
| 207L00000X Anesthesiology (Licence: NC 73023) | |
| 207L00000X Anesthesiology (Licence: AL 33357) | |
| 208VP0000X (Licence: FL ME85156) | |
| 207L00000X Anesthesiology (Licence: GA 72256) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2016-03-03 |