| NPI | 1619237294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: RI MD16804) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 55210) |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2022-02-21 |