| NPI | 1780674051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 75527) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 75527) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2007-07-08 |