| NPI | 1114188638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0047218) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC 135558) |
| 208D00000X General Practice (Licence: IN 01065823a) | |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2016-02-29 |