| NPI | 1770702300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NH 16466) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 042-0014210) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2022-02-28 |