| NPI | 1235700261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0104238) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT222692) |
| Enumeration Date | 2021-07-09 |
| Last Update Date | 2025-07-02 |