| NPI | 1083605919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: RI MD12313) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 219633) |
| 207L00000X Anesthesiology (Licence: RI 12313) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2013-10-03 |