| NPI | 1043280068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101236744) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 216847) |
| 207R00000X Internal Medicine (Licence: ME 015306) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2015-06-08 |