| NPI | 1649292814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 042-0007957) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 34111) |
| 207L00000X Anesthesiology (Licence: VT 042-007957) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2025-01-17 |