| NPI | 1093955171 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: RI DO00695) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101017739) | 
| 207L00000X Anesthesiology (Licence: RI 00695) | |
| Enumeration Date | 2009-03-02 | 
| Last Update Date | 2013-10-03 |