| NPI | 1629235221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: AL MD32686) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL MD32686) |
| 207R00000X Internal Medicine (Licence: AL MD32686) | |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2018-12-21 |