| NPI | 1952418949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ME 015571) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD029214L) |
| 207L00000X Anesthesiology (Licence: VT 0420011062) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2007-07-08 |