| NPI | 1740203587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 042-0006522) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: VT 042-0006522) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-07-08 |