| NPI | 1437507688 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A150684) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R75689) | 
| Enumeration Date | 2016-05-27 | 
| Last Update Date | 2019-05-14 |