| NPI | 1205396132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 61427) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ R77248) |
| 207R00000X Internal Medicine (Licence: AZ R77248) | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2025-03-28 |