| NPI | 1588928477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 39198) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 005661) |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2020-02-06 |