| NPI | 1962498592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 8360) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 042-0009762) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2012-04-20 |