| NPI | 1972653319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME0039555) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 30600) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2010-02-16 |