| NPI | 1043467194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MT199578) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 309757) |
| 207Q00000X Family Medicine (Licence: NE 5821) | |
| 207Q00000X Family Medicine (Licence: PA MD443133) | |
| 207SG0201X Medical Genetics Clinical Genetics (M.D.) (Licence: PA MD443133) | |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2022-04-05 |