| NPI | 1457797243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2016-00859) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT204428) |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2016-06-30 |