| NPI | 1417246653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME123604) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 294064) |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2023-09-25 |