| NPI | 1841450087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 042.0012611) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 237530) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2013-06-28 |