| NPI | 1225191166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2010-00290) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME MD23646) |
| 207L00000X Anesthesiology (Licence: VA 0101239795) | |
| 207L00000X Anesthesiology (Licence: VT 042.0011562) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-03-23 |