| NPI | 1154443547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 269524) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 042-001-1861) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2013-09-09 |