| NPI | 1770900953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: RI MD16619) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 274469) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2023-03-02 |