| NPI | 1871695478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 042.0011541) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 240916) |
| 207L00000X Anesthesiology (Licence: NH 19646) | |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2019-10-03 |