| NPI | 1992780613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 18959) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 032.0057670) |
| 207L00000X Anesthesiology (Licence: ME 1905) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2018-06-22 |