| NPI | 1083032676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101264161) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101264161) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2020-04-08 |