| NPI | 1487881108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: WI 62091-20) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 62091) |
| 207R00000X Internal Medicine (Licence: IL 125.055819) | |
| Enumeration Date | 2009-06-20 |
| Last Update Date | 2023-08-11 |