| NPI | 1831112937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 042.0009961) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 27979) |
| 207L00000X Anesthesiology (Licence: NJ 25MA07056300) | |
| 207L00000X Anesthesiology (Licence: NC 2006-01580) | |
| 207L00000X Anesthesiology (Licence: VA 0101239439) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2013-12-04 |