| NPI | 1477527919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 226286) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 042-0010981) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2011-04-07 |