| NPI | 1558306928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301093674) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GU M-2377) |
| 207L00000X Anesthesiology (Licence: VT 0420011014) | |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2023-04-25 |