| NPI | 1811973316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 79122) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 79122) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2007-07-08 |