| NPI | 1962664599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME113354) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT193424) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2013-11-05 |