| NPI | 1164489647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 78465) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: RI 9707) |
| 207L00000X Anesthesiology (Licence: RI MD09707) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2019-02-11 |