| NPI | 1124278478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 068004) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 236695) |
| 207R00000X Internal Medicine (Licence: MA 236695) | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2021-04-07 |