| NPI | 1528680188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 75460) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R78155) |
| Enumeration Date | 2020-05-17 |
| Last Update Date | 2025-07-29 |