| NPI | 1164837746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 80782) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 6920) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2018-08-16 |