| NPI | 1215946363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101241304) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 041029) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2019-08-30 |