| NPI | 1205814589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL 61068) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 61068) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2022-03-30 |