| NPI | 1124647797 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: RI MD20559)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: RI CLP05749)  | 
| Enumeration Date | 2020-04-13 | 
| Last Update Date | 2025-05-07 |