| NPI | 1225600638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2022024580) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2021027442) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2022-06-30 |