| NPI | 1053576744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 246204) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 236735) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2019-09-05 |