| NPI | 1417991571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: RI MD11483) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: HI MD-6958) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2010-12-06 |