| NPI | 1326303124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 266776) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 253015) |
| Enumeration Date | 2012-07-08 |
| Last Update Date | 2021-11-02 |