| NPI | 1548758477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 60103) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R77076) |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2022-10-17 |