| NPI | 1932166733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 45806) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME LT11187) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2018-07-20 |