| NPI | 1033321310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 262059) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2008-00247) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2017-10-04 |