| NPI | 1194716464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL 349574) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101051977) |
| 207R00000X Internal Medicine (Licence: FL 349574) | |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2023-05-26 |