| NPI | 1275946196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101280816) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 60385) |
| 207L00000X Anesthesiology (Licence: KY 52103) | |
| 207R00000X Internal Medicine (Licence: PA MT206465) | |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2023-12-13 |