| NPI | 1801802145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 56611) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: MA 56611) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2011-04-07 |