| NPI | 1376742809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P1844) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD444529) |
| 207R00000X Internal Medicine (Licence: PA MD444529) | |
| Enumeration Date | 2007-07-14 |
| Last Update Date | 2022-07-22 |