| NPI | 1285633164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: MA 227241) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: RI MD11381) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2015-08-07 |