| NPI | 1982662409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC TL33879) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME 102581) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2011-06-23 |