| NPI | 1588650907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 10017) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 042-0009185) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2015-01-26 |