| NPI | 1669996450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: RI MD18612) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 010600) |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2022-12-19 |