| NPI | 1639374259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 246965) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-232765) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2025-09-30 |