| NPI | 1568816601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101283071) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MD D0098644) |
| 207R00000X Internal Medicine (Licence: MD D0098644) | |
| 207L00000X Anesthesiology (Licence: MD D0098644) | |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2025-11-22 |