| NPI | 1184800971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL DO1004) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 20A9639) |
| 207L00000X Anesthesiology (Licence: AL 1004) | |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2023-03-15 |