| NPI | 1801864418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 042-0009075) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 190963) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2023-06-29 |