| NPI | 1194924654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P4868) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME MD29014) |
| 207R00000X Internal Medicine (Licence: CO 2277) | |
| Enumeration Date | 2007-07-15 |
| Last Update Date | 2025-02-04 |