| NPI | 1275066680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301507096) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 1275066680) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2024-12-31 |