| NPI | 1063736098 |
|---|---|
| Former Name | CARL CHRISTIAN MABRY |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 84795) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 282706-1) |
| 207L00000X Anesthesiology (Licence: NJ 25MA09290100) | |
| Enumeration Date | 2010-03-19 |
| Last Update Date | 2021-05-11 |