| NPI | 1073928271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 56079) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 259721) |
| 207R00000X Internal Medicine (Licence: MA 259721) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2018-10-10 |