| NPI | 1740395425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 229998) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 042.0015758) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2022-12-01 |