| NPI | 1144277609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 234074) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 24180) |
| 207L00000X Anesthesiology (Licence: VT 042.0012965) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2018-07-23 |