| NPI | 1649461765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 042.0013447) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 250263) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2016-09-02 |