| NPI | 1154761104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 30059) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE TEP 7060) |
| Enumeration Date | 2013-07-04 |
| Last Update Date | 2017-09-14 |