| NPI | 1023495678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 042-0015635) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 312113) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2022-04-01 |