| NPI | 1013234665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT MED-PHYS-LIC-60262) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR0053632) |
| 207R00000X Internal Medicine (Licence: PA MT196857) | |
| Enumeration Date | 2010-04-22 |
| Last Update Date | 2022-07-21 |