| NPI | 1649897638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS023414) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT020133) |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2024-06-05 |