| NPI | 1801467931 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: RI MD20538)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP05403)  | 
| Enumeration Date | 2021-07-09 | 
| Last Update Date | 2025-04-14 |