| NPI | 1356600803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 075483) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ R74032) |
| 207R00000X Internal Medicine (Licence: NY 63212) | |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2018-11-27 |