| NPI | 1205365889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D91303) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 271731) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2023-01-31 |