| NPI | 1538489638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 287400) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA T287400) |
| 207R00000X Internal Medicine (Licence: MA 244784) | |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2021-08-04 |