| NPI | 1164406419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 157809) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 157809) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2011-08-09 |