| NPI | 1487159091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 77192-20) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 77192) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2023-11-13 |