| NPI | 1316174477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 68810) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 48776) |
| 207L00000X Anesthesiology (Licence: UT 7769921-1205) | |
| 207R00000X Internal Medicine (Licence: AZ R71410) | |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2024-03-29 |