| NPI | 1649611617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MT224857) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 265512) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2022-03-04 |