| NPI | 1447634563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301506340) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MI 4301506340) |
| 208D00000X General Practice (Licence: MI 4301506340) | |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2026-08-22 |