| NPI | 1194772558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 0420010592) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 15758) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2022-12-12 |