| NPI | 1003012014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: RI DO00785) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: NH RT-2103) |
| 207L00000X Anesthesiology (Licence: MA 247764) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2015-06-09 |