| NPI | 1306423579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 1023782) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: RI MD20540) |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2025-07-24 |