| NPI | 1841298742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 042.0010702) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 12375) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2015-01-29 |