| NPI | 1285044313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60851653) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO TL.0005746) |
| 207R00000X Internal Medicine (Licence: TX BP10050008) | |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2018-06-11 |