| NPI | 1174017610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 1015724) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 275815) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2025-08-06 |