| NPI | 1851598577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: RI MD14766) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: MD 39020000x) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2016-02-10 |