| NPI | 1184971202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 65455) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.062440) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2023-11-03 |