| NPI | 1558708610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 66947-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP02816) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2022-07-21 |