| NPI | 1750737664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 282718) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: RI MD17363) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2026-05-18 |