| NPI | 1871868075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: RI MD16257) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 269792) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 269792) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: RI MD16257) | |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2023-02-20 |