| NPI | 1114212859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 37812) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN16014) |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2016-07-25 |