| NPI | 1639464290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA MD.206706) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD.206706) |
| Enumeration Date | 2011-06-12 |
| Last Update Date | 2026-04-23 |