| NPI | 1366738379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME123407) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC MMD.33855 LL) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL ME123407) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2022-03-21 |