| NPI | 1588661540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 80235) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: RI MD13783) |
| Enumeration Date | 2005-07-06 |
| Last Update Date | 2016-04-13 |