| NPI | 1730474271 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 17147) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 257767) | 
| Enumeration Date | 2011-06-13 | 
| Last Update Date | 2015-09-11 |