| NPI | 1508841610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 72159) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 72159) |
| 207VC0200X Obstetrics & Gynecology, Critical Care Medicine (Licence: MA 72159) | |
| Enumeration Date | 2005-12-12 |
| Last Update Date | 2021-04-23 |