| NPI | 1447791470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101278617) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT217953) |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2023-09-08 |