| NPI | 1619003084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 238969) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 238969) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2014-01-17 |