| NPI | 1194041285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 56796-20) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 1249302) |
| 207R00000X Internal Medicine (Licence: WI 56796) | |
| 207R00000X Internal Medicine (Licence: NC 164422) | |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2025-07-08 |