| NPI | 1861585192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 11974) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 162785) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2023-07-28 |