| NPI | 1265595136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA a44796) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A44796) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2025-09-11 |