| NPI | 1316010242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MO 2009001637) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MO 2009001637) |
| 207P00000X Emergency Medicine (Licence: MO 2009001637) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2025-04-17 |