| NPI | 1396703484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 042-0011115) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 340944) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2026-02-06 |