| NPI | 1073508636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME75392) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME75392) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2022-09-28 |