| NPI | 1033152590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 8834) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 48800) |
| 207L00000X Anesthesiology (Licence: VT 6882) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2011-09-22 |