| NPI | 1205028966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 066908) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 237017) |
| 207L00000X Anesthesiology (Licence: MA 249887) | |
| 207R00000X Internal Medicine (Licence: MD P21895) | |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2020-10-26 |