| NPI | 1528264330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 236851) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: RI DO00668) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2012-02-24 |